Ep 128 "What do you do when a flower's not growing?

Embark with us on a deep exploration into the world of neurodivergence, with our guide, Dr. Matt. Promising a journey of discovery, understanding, and empowerment. We dissect the challenges neurodivergent individuals face daily, discussing how they often become targets for bullying and exploitation. Dr. Matt brings his insights to the table with a patient story displaying how childhood trauma related to neurodivergence can linger. We emphasize the dire importance of educating children about consent and managing unsafe situations. 

We further delve into the aftermath of trauma, particularly focusing on survivors of sexual assault or molestation. Dr. Matt links the connection between mental and physical health in the healing process and emphasizes the role of diagnosis in leading individuals to the right resources and communities. We shed light on the concept of neurodivergency, particularly concerning autism, and navigate the challenge of achieving balance between labeling and understanding. 

As we bring this enlightening conversation to an end, we inspect neurodivergence's impact on gifted individuals. Sharing personal experiences with stimming behaviors linked to neurodivergence, we underline the difficulties of locating knowledgeable and affirming healthcare providers. Dr. Matt imparts invaluable insights into ableism in mental health treatment, specifically touching on ABA therapy for autistic individuals. Join us as we underline the importance of understanding, accommodating different brains and needs, and prioritizing equity in offering support. Tune in, absorb, and comprehend the critical journey of neurodivergence awareness with us.

The fibromyalgia starter pack  categorizes the episodes in a way that is more accessible for those new to fibromyalgia.

Transcript

Speaker 1: 0:49

When a flower is not growing, you don't blame the flower, you change the greenhouse. That quote and more will be discussed on the second half of the interview with Dr Matt. Remember that while I am a doctor, I am not your doctor. All signs and symptoms should be discussed with your own individual physician. And now on to this week's episode.

Speaker 2: 1:12

I've been adding to some of that listening to patients stories, which is really how you learn so much and how you've learned and expanded your understanding over the years and I think of somebody who is trying to navigate the social complexities that the neuro typical brain takes completely for granted and how that can be very complicated and when you are different in a just communication, social interpretation of what's going on in an event, and then a neuro typical group will unfortunately attack that person for just being different and that can be bullying. You know, childhood on a playground, more dyspraxia, not as coordinated, quirky and don't interact socially and maybe then preyed on because they don't know how to do the dynamics. I had a patient of mine who and this often happens in what I'm recognizing with a lot of these neuro divergences where a child, a patient who actually was seen for some chronic centralized pain and just in a visit was saying my son was diagnosed in middle school and I said, honey, this came for me, this is how my brain works already has history of ADHD but also on that more autistic spectrum and he has trauma going back to childhood when a older teenager said when he was like eight or sister was like six or something. Let's play a game of show and tell and it was take off your clothes and to this day he's like I feel terrible that I didn't do something about it. Now, when you think about that, is to understand the social complexity. That's an incompletely inappropriate thing, but not knowing how to navigate that may be more challenging for somebody who is more black and white in thinking and doesn't understand and I'm thinking of that as an example where maybe they are more prone to having. Unfortunately, not that anybody invites that, but sadly somebody almost senses that vulnerability and sadly takes advantage of that.

Speaker 3: 3:37

Well, yeah, I mean lions don't attack the healthy antelope, they attack the weird ones, the fringy bits. You know I mean it's in a jungle. You know I mean difference can be weakness. And you know I mean and it's funny because, like, one of my many jobs is I'm a sex educator and you know, and a lot of what I do is I put it through the lens of developing social and emotional skills, like, obviously, hopefully in a positive way, that it's like I'm attracted to you and you're attracted to me and we would like to do stuff together. We can communicate about that in a healthy, productive, pro-social way. Affirmative consent is a wonderful thing, right, but also and this is why good sex education starts in kindergarten is we're giving kids the explicit instructions on if someone is making you or your body feel unsafe. Here's what you do about that. And in the most recent research from this, 58% of kids said they didn't know who to contact in the case of a sexual assault 58% of kids. I mean that as a mental health professional and as a human, that breaks my heart, breaks my heart every day, right, and that's one of the reasons I've taken this on as a part of what I do. But to take this back to the idea of trauma, right, you know, blaming yourself for being sexually molested or assaulted is like a nose blaming itself for smelling a fart. It's not the nose's problem, right? The thing existed and happened and you were there and had to experience it. Right, it's not any one person's problem except for the perpetrator of said trauma. Right, and this is why empowering people, this is why we use the word survivor, not victim, right, because I survived this thing that happened to me, rather than, oh, I'm a victim. Victim is like an end of a sentence, a survivor is a semicolon like let's go, where's the rest of the story going. And so someone who navigates a situation like that, this so-and-tell thing, it makes them a survivor, it makes them not a victim. And it's so important that we understand that in mental health, for everything that it is right for mental health, it's the ability to hold multiple thoughts in your head at the same time. So, if the narrative in your head is that I should have said something, I should have done something, I wish that I had handled it differently, those are real thoughts and we cannot pretend that you're not having them and we cannot pretend those thoughts are not valid in the sense that your brain is telling you that story. But what can also be true is that it is not appropriate to ask an eight-year-old to navigate that situation. An eight-year-old should never be put in that situation right, and that's why that's why we describe people like that as predators. No one asks to be prey. Nobody would take on that role in the great circle of life. So it's this idea of and I get very passionate about this because once again, that thing being character energy it's my fault. I'm going to center myself in the narrative. It's easy to blame yourself for 9-11. If I had done a better job in the Iraq war in 92, this would have never happened. Do you have any idea how many billions of other things had to happen to get from the Iraq war to 9-11? Literally billions of things. You know how many billions of things had to happen for you to recover, for this thing to happen or not happen. To place yourself in the center of that is psychologically understandable. It's also not defensible. It's not my fault. My giants are one and one. It's not my fault to say Juan Barclay's ankle is sprained right. But it's easy to blame myself. I didn't wear my lucky socks, damn it. So if you're out there and you're reliving your own trauma, the first thing, take care of yourself. First thing, anchor yourself to the earth. You are here, it is 2023 and you are safe. The second thing is I hope you hear us when we say, like what's happening to you is a whole body thing. It is the bridge of medicine and psychology, because it is really a whole body experience and there isn't a pill for it. But your body can heal when you find the right environments that will support that healing. So what happened to you is bad. It is also not a life sentence.

Speaker 2: 8:26

And when you're looking at trying to get help getting through this. What role and I wrestle with this is? I've been thinking more deeper about neurodivergency, especially autistic style brains, and all of that is the word diagnosis and labeling and the balance of that. How important is recognition of this? If somebody does have this neurodivergent type brain, especially when there's more interoception as you get into middle school and older, into adulthood, this awareness that this is a real entity that not only you and other people have, how important is that? What role does that play?

Speaker 3: 9:20

So diagnosis is helpful because it puts a name to a thing and can connect you to a community and can connect you to service. One of the things that I often tell people are gifted is that you are likely to have stimming behaviors. Stimming behaviors are self soothing or self regulatory. For my entire life I do this. I rub my hands together and I've always thought it's because I had poor circulation. My hands were cold. My hands aren't cold. That's my wife. My hands are like ovens. I realize this is a stim. I do this when I'm overwhelmed, when I'm overstimulated. This is a way to regulate myself, even in that small moment, all of a sudden. That's the thing that fits under the neurodivergent umbrella and it locks in. Growing up as a gifted kid, I understood the intelligent part of it, the school part of it. When I was doing my research for my dissertation I started reading the developmental pieces, the asynchronic that comes with being neurodivergent. You can be chronologically 10 and have the intelligence of a 17 year old with the social skills of an eight year old. I always felt that way. I always felt like I logically understood what everybody was doing, but I didn't feel like I had the skills that everybody else, like they all had gone to some meeting and I missed that day. How do they know how to go to parties? I would like to go to a party. Is that a thing? Is there an assembly? It's like because their brains are wired to hit those social rhythms in a way that my brain is not wired to do so, or at least not for long periods of time Standing ones. Neurodivergence understands the whole piece of your brain and body, which means you're going to be more educated and more able to say here are the things I need. Because of my brain, I'm going to do my best to put myself in situations that play to those strengths rather than continue to be in environments and with people who don't support those strengths or even play to my weaknesses. I am a pretty successful professional. You also don't want me being the treasurer of your organization. I will lose the money. I will not keep track of it. It will be in a mattress somewhere and then we'll get audited by the state. I'm like how are we $703 short? I didn't steal it, I didn't spend it. I just don't know where it is. Don't make me the treasurer of your organization, but you damn well better believe that if you need a speaker for your event that needs to raise that money, then I will come to where you are and I will do a damn good job because that's what I'm good at. I've built my practice, my professional identity, around my strengths and it took me the better part of 40 years to get there, to a place where it's like, oh wow, this is what I'm best at. This is a crazy idea. I should do more of that. Give yourself permission, through a diagnosis, through self-reflection, to understand yourself and put yourself in this position to succeed. You don't owe anybody the experience of you being miserable because that's what you feel like, that's all you deserve or that feels like all you can do. I guarantee you there's a place out there and a job out there and a partner out there that will honor and accentuate those things rather than minimize them or ignore them.

Speaker 2: 12:53

And speaking of that diagnosis, it's seemingly difficult to find somebody who has experience. I think it's a challenge in the world of pediatrics. I think it's exponentially harder in the world of adults. Can you speak to that?

Speaker 3: 13:16

Yeah, this is one of the ways that the internet is a wonderful thing, because there are lots of lists of providers out there who are neurodivergent affirming, many of whom are autistic or ADHD or dyslexic or gifted themselves, myself included. I center neurodivergence in what I do because that's who I am, and I think the reason I can connect with kids is that I can say listen, I know what it's like to be eight and be smarter than your teacher. Here's how you live through that situation. And kids go wait, what Are we allowed? To say that I'm like, yeah, you are in this space, you are, and if you don't know that person, if there's not one in your community, you shoot me an email and I will help you find that person, because we are out there. There are not enough of us, but we are out there and I can speak for the vast, vast majority of my colleagues. Let's say that we are always happy to talk to your boss, hr department, the medical system, the legal system, the educational system, so more people know about what these brains are, what these brains do and how these brains can be best served, because then what we're doing is we're living a world of equity. Everybody gets what they need, and that is, I think, foundational to best practice.

Speaker 2: 14:36

Is autistic training to niche? Is that a standard part of someone's training in the world of psychology or is that the special interest that somebody grooms because of their own interest, often maybe for themselves or a family member, or because they find it very intriguing?

Speaker 3: 14:54

It's a lot of the latter. So my very first job in mental health was I worked for a clinic that used ABA, or applied behavioral analysis, and that was for many years the gold standard of treating autistic people. And now we know that that is ableist. It's not best practice. Now there are lots of providers out there that use ABA appropriately, but the idea is that people within the autistic community say ABA is about shaping my behavior to be neurotypical and I can never be neurotypical. Wouldn't it be better to help me understand that this is a stim? So if I'm feeling anxious, let me stim and then get back to work, rather than training that stim out of me, which is a thing that may never work? Actually, it's so hard in mental health to make any sweeping declarative statements so I'm not going to do that because I'd rather not get sued. But the idea here is, what we're seeing is more and more providers be neurodivergent, affirming and not say I've got to cure you, I've got to fix you. I have this conversation. It's almost always dads actually. They've got a neurodivergent kiddo. Let's say you've got an autistic high schooler and dad's like oh, I was a wrestler. I was a very good wrestling. Wrestling taught me teamwork and sportsmanship and resilience and I got super fit and I think my son should do that and I'm like that's awesome, what a great idea. I'm so happy wrestling was helpful for you. Your kid with significant sensory needs and social anxiety will never be a wrestler. It's not a thing that they're going to do unless that kid turns around and says, yeah, dr Matt, I want to wrestle. That'll help them wrestle, but it starts with a kid's interest. The best way to be neurodivergent affirming is to say what are your goals and how can I help you get there? There's no reason you cannot be an autistic actor or an ADHD accountant or a gifted florist. But the idea is I gotta know where you wanna go and I will do everything in my power to help you get there. It's about putting on the clothes you wanna wear, rather than me fitting you for a suit, because that's what I think you should wear. So that's what providers are starting to do, and the more of us do that, the more of us see the power of that. So it becomes this sort of groundswell of change.

Speaker 2: 17:18

I was on a golf course and random single golfer myself, three people I didn't know, very good golfers Third last hole finishes up and this person gave me some golf tips that I needed. I asked about family and had adopted. Their last child was adopted, who was on the spectrum and was having a lot of struggles, and I mentioned why I have a special interest in. I mentioned that generically earlier that I take care of people who have challenges, but I didn't explain what that was, just casually. I'm a pediatrician, internist and felt an email shared said that I'll be interviewing you and also with on the upcoming podcast in the question and having the importance of trust in the parent-autistic child relationship or in general partner relationship, and said what I take away from this is a question will my daughter ever trust me completely? I have to assume and remind myself the answer is most likely. No doesn't mean I will stop trying, but it is most likely the reality thinks again and I think that somebody who I think 18, 16 years of parenting since the adoption and I don't know all the details, but there's been a lot of struggles with autism and ADHD in the worst case scenario and I think there wasn't a manual, I don't think that the dad had kind of a modern understanding of how to best parent somebody who has gone through this. If they are at that stage and I said, no, this doesn't mean I texted back, this doesn't mean that this is never gonna happen repairing that trust for people who it didn't go the right way and they didn't know how because they didn't have that education. What would you say to the parents out there who are later in the game and may have done things that were counterproductive and not supportive because they didn't know better, and then moving forward, so I mean, to paraphrase Maya Angelou, do the best you can until you know better than do better.

Speaker 3: 19:37

So you can't fault yourself for doing what you thought was right at the time If you can honestly say you thought that was the best thing at the time, right? I mean, one of my go-to therapy sayings is the best time to have started change was five years ago. The second best time is right now. Right, if I've been waiting to go to an internist because my gut does a weird thing and I've been putting it off for four years. But listening to this podcast makes me go talk to somebody like you and I get diagnosed with the IBS so I can get medicine for that, yeah, my life would be better if I'd done it four years ago. It doesn't mean I don't benefit from doing it now, right, and that's that holding two thoughts in your head thing. So you know, don't treat trust like an all or nothing thing, right? Because if you did, you'll never be happy. The idea here is how can I build more trust, just like how can I build more resilience? Now, the way to build more trust is not to do whatever your kid wants all the time. It's to set and hold appropriate boundaries and communicate openly and honestly about that stuff, like I don't want you driving in this snowstorm, not because I think you're a bad driver, but because it's just not safe to drive in the snowstorm. Your kid may not like that, your kid may not believe you, but that is best practice, right? And it is not just a singular event but a broader constellation of open, honest, clear communication. Repeat, repeat, repeat, repeat, repeat. And then you look up and three years from now you have built a lot more trust and you'll benefit from that for as long as you have that relationship.

Speaker 2: 21:18

And to that I've learned a lot just in reading Barry Presence Uniquely Human try to help understand, going through neuro tribes, trying to help understand things better. Do you have any books that are a good guide for two groups One, if you are living with this yourself, and or if you're trying to support somebody. But your brain you don't, you know. It's kind of like nobody knows how their brain works because that's the only brain they know until you work with other people and experience the world. So if you have any books or the first group is if you are having this of any ones that you recommend that are a couple that are valuable.

Speaker 3: 22:01

My colleague and friend, paula Prober, wrote a book called your Rainforest Mind and it has spawned a sequel and then the journal, which are both exceptional. So I mean, it is really like, oh, this is my brain on a plate. Thank you for understanding this, paula. I don't know how you looked into my skull, but good for you. Another phenomenal one is how to Be Everything by Emily Wapnick. I can tell you, that book changed my life. I read that book and like, oh cool, I'm allowed to put my needs first. I'm allowed to be whatever I want to be. So that is another great book. If you are in the kids space, my colleague and friend, emily Kircher Morris have two books Teaching Twice Exceptional Learners and Raising Twice Exceptional Children. Both of them are phenomenal. They're on my shelf. I will use them for my own children someday, I'm quite certain, but not there yet. And I could say a lot more.

Speaker 2: 22:58

What do you think of NeuroTribes?

Speaker 3: 22:59

Love NeuroTribes. I mean, I just like flew through it.

Speaker 2: 23:03

It's very well written. This whole story gets into the history, the characters involved in the development of understanding. It's like a page-turner to me.

Speaker 3: 23:13

Oh yeah, I mean, it's really amazing. It's oh, you know one that's. It wasn't on my original list but it just popped into my brain Chloe Hayden's Different, not Less. It's a very different kind of book. I adore that book. I really enjoyed it. Living Gifted, Lisa Van Gamert it's another classic Everything by Emily Kircher Morris. You know, I mean, there's just so many good resources out there and the best thing about it this isn't like what to expect when you're expecting like it's the one book you read, the one book Like for your flavor of neurodivergence, whether it's gifted or autistic or ADHD or dyslexic or OCD or some combination thereof. There's a book and a sub community that exists for it. And if you punch that stuff into Google or email me or somebody like me, we'll connect to those places, because the best thing you can do for yourself is find resources and find community. And I think, fundamentally, this work always comes down to me for a quote. I remember that's when a flower's not growing, you don't blame the flower, you change the greenhouse. So understanding your brain and body is about creating your own greenhouse and that's where you're going to do your best growing.

Speaker 2: 24:30

That's a very neurodivergent creative. I love that. Yeah, I mean right, it's who I am. I always come out of the borrow that if your ear itches sometime like gosh, darn it. Lens is using that greenhouse quote again.

Speaker 3: 24:44

Classic lens Middle of.

Speaker 2: 24:46

January, yeah, but all those good, a lot of good ideas you can borrow and shaped. You know. What's interesting is, I think that the medical community, the physician community, I think, is very behind this concept, especially in adults, especially in those who fall out of getting that diagnosis, that is, the educational diagnosis for needing that extra quote help. It seems that this is an awareness and when you start to know what to look for, it seems like there's, as I'm reading more, that there are a lot more people who have this that are masking. Here's a question that I'll finish with. This is a patient of mine who was struggling on the spectrum, and so we're learning about this quote, trying to find somebody who was able to quote, make a diagnosis. I said whether you have a formal diagnosis or not, that's another question, but she asked me some questions and she said there is a strong genetic component in autism. With that being said, is there a correlation between the parent's autistic functionality level and their child's autistic functionality level, assuming they passed autism on to their child? In other words, would, for lack of better term, high functioning mother be more likely to have a high functioning child, or does autism manifest differently in everyone?

Speaker 3: 26:26

I mean, we know autism is highly heritable. We know intelligence is highly heritable. We also know that individual differences between partner and genetics and epigenetics throw a lot of variables in there. So I wouldn't say in my professional opinion that one parent's neurotype would predict an offspring's neurotype. It makes them significantly more likely to be neurodivergent in some way. But an example I use in this all the time is you think about Peyton Manning and Archie Manning, very famous quarterbacks. Peyton Manning is a Hall of Fame. I think Eli probably will be. Archie Manning was their dad, also a Hall of Fame quarterback. Archie Manning's dad was not a quarterback but he invented the burglar alarm. So they're all gifted humans, but their giftedness shifted. I worked with a young woman many years ago. This girl was I mean, if she's the next Neil DeGrasse Tyson in 20 years, it would not surprise me. She's incredible. She knew more about astrophysics as an eight-year-old than I do as a. Well, I was 36 at the time and her dad was like I didn't finish high school, where did she come from? And I'm like well, you've won best auto mechanic in your county, x number of years in a row, like I'm going to argue that you're probably gifted in terms of mechanical engineering and stuff, and your kiddo's flavor of that fits a little bit better in school than yours did. You were probably not super interested in school, except for shop class. He's like oh, I love shop class. He's like but they kept making reread books in English and I didn't want to read the books and I'm like, yeah, right, so that's the thing. Divergence predicts divergence, but it doesn't really predict type as well.

Speaker 2: 28:21

Yeah, I think that's a great answer. Do the benefits of therapy outweigh the possible stigma of an autism diagnosis for a child?

Speaker 3: 28:31

Absolutely Right. If you diagnose one of your patients with type 1 diabetes, you tell them right.

Speaker 1: 28:40

Of course.

Speaker 3: 28:41

So they can get resources and add communities and change their diet and all those things. I cannot pretend there isn't stigma for autism, just like there's not stigma for T1D. But part of being neurodivergent and affirming is saying this is how your brain works, this is who you are. These are probably the ways it's going to impact you. Let me help you navigate that moment Right, and I'm going to give you the tools and the resources to do so. So we cannot pretend there's not stigma, but I would rather your kid know why they spin when everybody else glides and then we can use that to empower them and center their self in who they want to be.

Speaker 2: 29:22

And I think that's so important for the individual who's going through this, also for their family to help understand, and I would bet many people who are therapists in this world, if they aren't neurodivergent, may have had a brother or sister who was, and they had a deep heart to help care for them better. I've talked about this question. There are so many resources, seems like, for kids If there is an adult who may be newly diagnosed I know you talked about online support. Any other thoughts on how to process that as an adult, especially if they've never really sat on it very long up until a new diagnosis?

Speaker 3: 30:01

There are a lot of Facebook communities that you can start at. Mensa has meetup groups. The actually autistic movement there's a lot of stuff in that space. The octopus was it the octopus society? The octopus movement, some of the octopus, I think it's the octopus movement. The idea there is that it's never too late and we want you to be a part of those communities. We want you to have a seat at that table. We don't try to gatekeep these things. I always say if you have privilege, you build a bigger table, not a higher fence, right. So you know, I mean, and you may not be comfortable going to a Mensa meeting, right, but if you love Dungeons and Dragons and that scratches your itch and you can find a meetup, did you Dungeons and Dragons? You are, for all intents and purposes, going to a neurodivergent meetup. They may not know it, but I would bet you a steak dinner if that's what's happening. Start with interests and interests build connections with spilled community which will likely branch into other communities. One of my colleagues started in the gifted world when her kid got into chess, which got him into LARPing, live action, role play, if you don't know. Which got him into archery, which got him into physics, because archery is physics, and they realized he's really great at STEM. And then she made it all the way back to gifted, because the really good STEM school is a gifted school. And she goes oh my gosh, my kid's been a gifted kid the whole time. That's my journey that I had to walk all the way around the block to get back to my house, right, but sometimes that's what it takes, so it doesn't matter where you start, as long as you start.

Speaker 2: 31:42

Yeah, starting that journey and hopefully for people who are listening to this podcast, many who I did a survey on one of the Facebook fibromyalgia groups and I asked a simple question with three choices. I said how many of you think that you have a neurodivergent type brain and choices where, yes, probably, I'm not sure, but likely, I'm pretty sure not. And about a third said I'm pretty sure, yes, a third said I might have, but I'm not sure, and a third said no. So I think there's a lot of overlap in the fibromyalgia world that many people don't even know how that impacts potentially some of the pots Overlapses, you probably knowing with a lot of these physical things that people have and we're learning and that's that intersection here with the autism world and these medical conditions and a lot of people don't even know these are occurring and people are. A lot of the silos are occurring and so I think there still is a stigma out there and I think it comes from misunderstanding and that's we're trying to find somebody and having those resources, like you said, online. I take care of neurodivergent people when I talk about these other overlapping conditions. Not a lot of people do that. As one of my patients said to me who's neurodivergent? You sure like taking care of us people who live on the island of misfit toys, and sometimes it can feel like that and hopefully what I'm doing in my small role can help so that this ends up with the next generation of physicians and physicians who are neutral to be. Oh, once you recognize that may be part of it. And it's as I'm starting to being aware of this and then asking some simple screening questions, like all of a sudden the air comes out and this is just that acceptance that the doctor understands somebody like me. I kind of joke. We like to say you're not that special because I take care of a lot of people who have similar kinds of things, even though everybody's got their own unique issues. Any last thoughts as we wrap up here.

Speaker 3: 33:59

Any time I do a podcast like this, you know there's no way that we can cover everything. It's just it's too big a topic, it's a giant thing, but hopefully this gave you some threads to pull. And you know, and the work starts now and you might be being yourself up not starting it sooner, but it doesn't matter. All you can do is start right now. You can start where you're at and you will find that the more you understand about your brain and your neurodivergence, the more full and authentic your life will be. And that's what I want for you, and that's what Dr Lenzla wants for you, and that's what your loved ones want for you. And so you know, give yourself permission to put yourself first, and, and if that's through neurodivergence, then welcome to the club.

Speaker 2: 34:47

Awesome. Well, we'll have your contact information and thanks again. So much for being here.

Speaker 3: 34:55

It was a blast. Thanks for having me.

Speaker 1: 34:57

That's where we will end this week's episode. If you have any questions or comments, please email me at drmichaelenzetchemailcom. Until next week, go team Vibro you.